Community-based Cardiac Rehabilitation Led By Ceps Improves Physical And Mental Health Of Phase 2 Patients

Abstract

Post-event phase 2 cardiac rehabilitation (CR) improves cardiorespiratory fitness (CRF) and quality of life (QoL) while reducing depression and anxiety. Unfortunately many patients decline hospital-based CR because it is inconvenient to attend the facility. Community-based programs have been developed to increase CR program accessibility however; these programs often lack adequately-trained staff and it remains unclear how effective they are. PURPOSE: This study sought to examine the effectiveness of a community-based cardiac rehabilitation exercise program lead by clinical exercise physiologists on CRF, self-reported QoL, depression and anxiety in adults with CVD. METHODS: Participants (n=43; 86% male) with CVD (63.4 ± 9.6 yrs) were referred to a community-based CR program located in Auckland, NZ. All participants underwent baseline and follow-up assessment which included a ramped ECG monitored maximal exercise test with gas analysis, a QoL (Short Form-36), and Hospital Anxiety and Depression Scale (HADS) questionnaire. Participants completed 3 weekly sessions of aerobic (40-70% VO2R), resistance (1-2 sets; 12-15 reps at 40-80% 1RM) and flexibility exercise, totalling approximately 60 minutes/session. Significantly different (p<.05) pre- vs. post-program values were identified by dependent t-tests. Data are the mean ± SD. RESULTS: Participants attended 83.3% ± 16% of total prescribed sessions. Post-program CRF significantly increased (27.5 ± 7.3 to 30.4 ± 7.4 ml.kg-1.min-1) despite no significant increase in HRpeak (149.5 ± 19.8 to 148.5 ± 21.9 bpm) and respiratory exchange ratio (1.01 ± 0.1 to 1.01 ± 0.1) during maximal exercise testing. SF36 component scores for physical (44.2 ± 10.6 to 51.1 ± 7.3) and mental health (47.2 ± 13.3 to 52.9 ± 6.9) increased while the HADs anxiety (4.2 ± 3.2 to 3.5 ± 2.9) and depression (2.9 ± 3.0 to 1.4 ± 1.4) scores were significantly lower post-program. No deaths or medical events occurred during maximal exercise testing or during regular exercise programming. CONCLUSIONS: Twelve weeks of community-based exercise cardiac rehabilitation led by clinical exercise physiologists is safe and effective for increasing CRF, and QoL while reducing depression and anxiety in phase 2 CR patients.